By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
During the next three months, health systems nationwide will begin to transition new graduates into their practice settings. This year’s new graduates have had more direct clinical time than nurses who graduated in previous years. Still, their current skills will not be enough for hospitals’ high-acuity and high-volume environments today. The patient acuity-nurse experience gap has never been wider. There are fewer experienced nurses on acute units to serve as their preceptors and mentors.
Nursing faculty share that students are very anxious about their skills. New research from NYU Professor Jonathan Haidt indicates that today’s new graduates are part of a generation that grew up with the trifecta of cellphone communication, 24/7 internet connectivity, and constant comparison on social media. Their baseline levels of stress, anxiety, and clinical depression are double those seen in prior generations.
Many of these graduates worry they are transitioning into turbulent environments where they feel psychologically unsafe and cannot meet the professional expectations of some organizations. They are not wrong to have these concerns. Although retention rates among experienced nurses improved in 2023, new graduate turnover remains very high, with some new nurses leaving even before they complete orientation.
We as leaders must ensure that transitional experiences are designed to give them a strong foundation, develop professional efficacy, and help them feel psychologically safe. It is not the new graduate’s fault that the healthcare environment is turbulent and that there are massive health access issues. It is not the faculty’s fault that new graduates are not fully work-ready. If we want these young nurses to succeed, we must do more for them. Orientation for most will need to be longer. Preceptor expectations may need to be tempered. Below are some wants and needs of this young workforce to consider as you plan their onboarding:
New Graduate Wants
- Leaders who focus on their strengths and contributions rather than their deficits.
- Leaders who are inclusive and make sure new staff develop solid connections and relationships with other staff.
- Optimistic leaders who say thank you and make them feel special.
- Leaders who help them track their progress and growth.
- Leaders who are coaches, not bosses.
- Leaders who discuss career planning and their career goals.
- Leaders who pay them fairly.
- Leaders who honor work-life balance and nurse well-being.
- Leaders who don’t give them more complex assignments than they can manage.
New Graduate Needs
- Leaders who listen more than they talk.
- Leaders who mind the gap between patient needs and new nurse capabilities – and who don’t expect too much too soon.
- Leaders who build teams where psychological safety is a core value.
- Leaders who choose preceptors that help new graduates develop stronger critical thinking skills.
- Leaders who are not afraid to give professional feedback about what the new graduate needs to start, stop, or continue doing.
- Leaders who will teach them conversational skills and team backup.
- Leaders who understand their high stress and anxiety levels and discuss well-being strategies.
- Leaders who promote a growth versus fixed mindset in competency development by reminding new nurses – they can’t do this yet but will soon.
- Leaders who plan comprehensive orientations and provide step-by-step guidance.
- Leaders who create environments of civility and teamwork.
When transitioning your new graduate nurses this year, begin with the end in mind. One nurse leader told me her team has an audacious goal to retain 95% of her new graduates through the first year. Before the new graduates start each summer, she challenges her team with the following scenario: It is July of 2025, and we have only lost one of our new graduates. What did we do to make that happen? There is wisdom in that question for all of us.
© emergingrnleader.com 2024
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